Mod. 2 Flashcards
A 57-year-old patient presents with a persistent cough, unexplained weight loss, and hemoptysis. A chest X-ray reveals a mass in the right upper lung lobe. A biopsy confirms malignant neoplasm. Which nursing intervention should take priority?
A) Prepare the patient for chemotherapy education.
B) Assess oxygenation and prepare for possible airway compromise.
C) Discuss end-of-life planning and palliative care options.
D) Schedule the patient for a nutrition consult to prevent cachexia.
Rationale: The key trap is assuming that cancer treatment is the priority when, in reality, airway compromise is the most immediate concern.
A patient is diagnosed with an aggressive malignant tumor. The nurse understands that malignant neoplasms exhibit which of the following characteristics?
A) Slow, well-differentiated, and encapsulated growth.
B) Localized spread, causing symptoms only at the origin site.
C) Rapid, poorly differentiated, and the ability to invade nearby tissues.
D) Predictable growth patterns, allowing for early intervention.
Rationale: Option A describes benign tumors, while option D is misleading because cancer growth is often unpredictable.
A pregnant patient with Jewish ancestry expresses concern about Tay-Sachs disease. The nurse explains that this disorder is caused by:
A) A deficiency of the enzyme phenylalanine hydroxylase, leading to toxic protein buildup in neurons.
B) A mutation in the HEXA gene, resulting in progressive neurodegeneration due to lipid accumulation in neurons.
C) A trinucleotide repeat expansion in the FMR1 gene, affecting synaptic development.
D) A deletion on chromosome 21, leading to cognitive impairment and developmental delay.
Rationale: The key challenge here is avoiding the trap of misidentifying the genetic disorder, as answer choices resemble PKU, Fragile X syndrome, and Down syndrome.
A nurse is caring for a patient undergoing chemotherapy who develops leukopenia and thrombocytopenia. Which action by the nurse requires immediate intervention?
A) A nursing assistant assists the patient with oral hygiene using a soft-bristled toothbrush.
B) A family member brings fresh fruit and flowers to the patient’s bedside.
C) The nurse performs hand hygiene before administering IV antibiotics.
D) The patient requests a visit from a hospital chaplain for emotional support.
Rationale: Fresh fruit and flowers can introduce bacteria or fungi, increasing the infection risk in an immunocompromised patient.
A patient with metastatic breast cancer is undergoing chemotherapy and reports new-onset numbness and tingling in the fingers. The nurse recognizes that this symptom is likely due to:
A) Central nervous system metastasis
B) Peripheral neuropathy caused by neurotoxic chemotherapy agents
C) Hypocalcemia due to tumor lysis syndrome
D) Anemia-related hypoxia leading to neurological changes
Rationale: Peripheral neuropathy is a common side effect of certain chemotherapy drugs like vincristine and paclitaxel.
A 16-year-old male presents with tall stature, gynecomastia, and difficulty with social interactions. Genetic testing confirms an extra X chromosome. Which statement by the nurse requires correction?
A) “This genetic condition is called Klinefelter syndrome, which affects only males.”
B) “Males with this condition have a 50% chance of passing it to offspring.”
C) “Testosterone therapy may be recommended to improve some symptoms.”
D) “This condition is often diagnosed during puberty when secondary sexual characteristics develop.”
Rationale: The incorrect statement is B—Klinefelter syndrome is not inherited in a simple Mendelian pattern, as it results from a random chromosomal nondisjunction.
A 58-year-old patient presents with unexplained weight loss, fatigue, and chronic cough with hemoptysis. A biopsy reveals undifferentiated cells with rapid mitotic activity. Based on this finding, what is the most appropriate classification of the tumor?
A) Benign tumor
B) Malignant tumor
C) Dysplastic neoplasm
D) Carcinoma in situ
B) Malignant tumor
Malignant tumors are undifferentiated, have rapid mitotic activity, and invade surrounding tissues.
A nurse is educating a patient about the stages of carcinogenesis. Which statement made by the patient indicates the need for further teaching?
A) “Initiation involves DNA damage from carcinogens.”
B) “Promotion is the stage where the cancer cells begin uncontrolled growth.”
C) “Progression is the stage where the cancer remains localized but aggressive.”
D) “Metastasis occurs when cancer spreads to distant sites.”
C) “Progression is the stage where the cancer remains localized but aggressive.”
Progression refers to the stage where the tumor grows, invades tissues, and can metastasize.
A 45-year-old woman undergoes a biopsy for a suspicious breast lump. The pathology report states ‘Grade 3, T2N1M0.’ What does this indicate?
A) The tumor is well-differentiated and has not spread to lymph nodes.
B) The tumor is poorly differentiated, 2 cm in size, and has spread to regional lymph nodes.
C) The tumor is in early stages with no lymphatic involvement.
D) The cancer has metastasized to distant organs.
B) The tumor is poorly differentiated, 2 cm in size, and has spread to regional lymph nodes.
T2 = tumor is between 2-5 cm, N1 = regional lymph node involvement, M0 = no metastasis.
Which of the following laboratory findings would a nurse anticipate in a patient with advanced-stage malignancy?
A) Increased platelet count and hyperglycemia
B) Leukocytosis with a left shift
C) Anemia, leukopenia, and thrombocytopenia
D) Elevated albumin and normal hematocrit
C) Anemia, leukopenia, and thrombocytopenia
Advanced malignancy often leads to bone marrow suppression, causing pancytopenia.
A newborn is diagnosed with phenylketonuria (PKU). Which of the following interventions should be implemented immediately?
A) Begin a high-protein diet to support growth
B) Restrict dietary phenylalanine to prevent neurological damage
C) Administer IV fluids with high glucose concentration
D) Initiate physical therapy to prevent motor delays
B) Restrict dietary phenylalanine to prevent neurological damage
PKU is managed with a low-phenylalanine diet to prevent intellectual disability.
A male patient presents with gynecomastia, small testicles, long limbs, and sparse body hair. Genetic testing confirms the presence of an extra X chromosome. What is the most likely diagnosis?
A) Turner Syndrome
B) Klinefelter Syndrome
C) Fragile X Syndrome
D) Marfan Syndrome
B) Klinefelter Syndrome
This XXY chromosomal disorder presents with gynecomastia, small testes, and infertility.
A nurse is counseling a pregnant woman whose ultrasound suggests the presence of a cleft lip and palate in the fetus. The patient asks what caused this condition. The best response by the nurse is:
A) “It is likely caused by a single gene mutation inherited from one parent.”
B) “This condition is due to a spontaneous chromosomal deletion.”
C) “It is a multifactorial disorder influenced by genetic and environmental factors.”
D) “This occurs only in families with a history of cleft palate.”
C) “It is a multifactorial disorder influenced by genetic and environmental factors.”
Cleft lip/palate results from multiple genetic and environmental influences.
Which of the following findings is characteristic of Turner Syndrome?
A) A tall stature with long limbs
B) Hyperpigmentation and neurofibromas
C) Webbed neck, low-set ears, and short stature
D) Progressive intellectual decline and loss of coordination
C) Webbed neck, low-set ears, and short stature
Turner Syndrome (45, XO) is characterized by short stature, webbed neck, and ovarian dysfunction.
A patient with a history of hypertension develops left ventricular hypertrophy. What cellular adaptation is occurring in the myocardium?
A) Hyperplasia
B) Hypertrophy
C) Dysplasia
D) Atrophy
B) Hypertrophy
Left ventricular hypertrophy results from increased workload, leading to enlarged myocardial cells.
Which of the following scenarios is an example of metaplasia?
A) An athlete develops larger muscle mass after intensive training.
B) Chronic acid reflux leads to squamous cells in the esophagus transforming into columnar cells.
C) A patient with chronic lung disease develops alveolar fibrosis.
D) A child’s thymus gland shrinks as they age.
B) Chronic acid reflux leads to squamous cells in the esophagus transforming into columnar cells.
This describes Barrett’s esophagus, an example of metaplasia (reversible cell type change due to stress).
